2013年太原市空气污染物与出生缺陷关系的病例对照研究

A case-control study on relationship between air pollutants and birth defects,Taiyuan city,2013

目的研究空气污染物(PM_(10)、PM_(2.5)、SO_2、NO_2、CO、O_3)对出生缺陷发生的影响。方法收集太原市6个城区中怀孕日期为2013年、妊娠结局为出生缺陷的产妇为病例组,同时收集居住地址与病例组为同一街道办事处、妊娠结局为健康新生儿的产妇为对照组。用2013年太原市空气污染物每日平均浓度值估计孕期暴露水平。采用条件Logistic回归模型进行分析。结果怀孕中期PM_(10)和PM_(2.5)每增加1μg/m^3,发生出生缺陷的危险度分别为1.103(95%CI:1.088~1.118)、1.216(95%CI:1.187~1.245);怀孕后期PM_(10)和PM_(2.5)每增加1μg/m^3,发生出生缺陷的危险度分别为1.063(95%CI:1.053~1.074)、1.100(95%CI:1.084~1.115)。怀孕初期NO_2和O_3每增加1μg/m^3,发生出生缺陷的危险度分别为1.687(95%CI:1.570~1.812)、1.029(95%CI:1.022~1.036)。CO在怀孕初期和怀孕中期每增加1μg/m3,发生出生缺陷的危险度均为1.007(95%CI:1.006~1.008)。SO_2在怀孕初期、中期、后期,每增加1μg/m^3,发生出生缺陷的危险度分别为1.032(95%CI:1.022~1.042)、1.083(95%CI:1.071~1.096)、1.036(95%CI:1.029~1.043)。结论空气污染物与出生缺陷的发生有关。

Objective To study the association between air pollutants （PM10, PM2.5, SO2, NO2, CO, O3 ） and birth defects. Methods Delivery women were collected whose pregnancy outcomes were birth defects as the case group, those whose pregnancy outcomes were healthy newborns as the control group from the same residential address, the date of their pregnancy was all in 2013 in the six districts of Taiyuan city. Exposure levels during pregnancy were estimated by the average density of air pollutions per day in Taiyuan city in 2013. The data were analyzed using conditional logistic regression model. Results For birth defects, the odds ratios were 1. 103 （95% CI ： 1. 088 1. 118） and 1. 216 （95% CI ： 1. 187- 1. 245）respectively,when PM10 and PM2.5 increased 1 μg/m^3 in the second trimester. The odds ratios were 1. 063 （95% CI ：1. 053-1. 074 and 1. 100（95% CI ：1. 084-1. 115） respectively,when PM10 and PM2.5 increased 1 μg/m^3 in the third trimester. The odds ratios were 1. 687（95% CI ：1. 570-1. 812）and 1. 029（95% CI ：1. 022-1. 036）respectively,when NO2 and O3 increased 1μg/m^3 during the first 3 months of pregnancy. The odds ratios were all 1. 007（95% CI ：1. 006- 1. 008）,when CO increased 1 μg/m^3 in the first and second trimester. The odds ratios were 1. 032 （95% CI ：1. 022- 1. 042）, 1. 083 （95% CI ： 1.071-1. 096）, 1. 036 （95 % CI ： 1. 029-1. 043） respectively, when SO2 increased 1 μg/m^3 in the first and second and third trimester. Conclusion The occurrence of birth defects is associated with air pollution.